Beryl Valentine, MS
Rosalind Franklin University of Medicine and Science
Chicago, Illinois
Disclosure information not submitted.
Paul Cooper, MD
Resident
University of Illinois, Chicago, IL, Illinois, United States
Disclosure information not submitted.
Brenna Kouzoukas, RN, MSN, FNP-BC, ANP
Nurse Practitioner
n/a, United States
Disclosure information not submitted.
Tejashri Ganbote, MBBS
Research Coordinator
Advocate Children's Hospital, United States
Disclosure information not submitted.
Pavan Sreerama, BS
DO candidate
Midwestern University, United States
Disclosure information not submitted.
Nekaiya Jacobs, MD
Pediatric Intensivist
Advocate Children's Hospital, United States
Disclosure information not submitted.
Vinod Havalad, MD
Pediatric Intensivist
Advocate Children's Hospital, United States
Disclosure information not submitted.
Varsha Gharpure, MD, FAAP, FCCM
Pediatric Intensivist
Advocate Children's Hospital, United States
Disclosure information not submitted.
Title: Clinical Characteristics of Infants with Severe Acute Respiratory Syndrome CoronaVirus- infection
Introduction: Two types of presentations are reported among children with Severe Acute Respiratory Syndrome CoronaVirus- infection (SARS CoV-2): Multisystem Inflammatory Syndrome in Children (MIS-C) and CoronaVirus Disease-19 (COVID-19, classic viral pneumonia with hypoxia). Limited information is available about the clinical course of infants.
Methods: Data of symptomatic children with laboratory-confirmed SARS-CoV-2 infection or MIS-C admitted to the two campuses of Advocate Children's Hospital, Illinois, between 3/1/20 to 3/31/21 was reported to the Society of Critical Care Medicine's Virus Infection and Respiratory Illness Universal Study registry. Children up to one year of age were included in this study. Data are reported as a percentage, number, or median (IQR).
Results: Out of 192 children below 18 years of age admitted during the study period, 40 met the inclusion criteria [age: 0.16 years (0.07-0.35), 63% males, 73% Whites, 43% Hispanic, 22% - pre-existing conditions]. Fever was the most common (87%) presenting symptom. Viral pneumonia was diagnosed in 3 patients and MIS-C in 2. The hospital length of stay was 1.92 days (1.50-3.45) with no in-hospital mortality. Three needed ICU admission. Six patients needed respiratory support [invasive mechanical ventilation: 2 (1-complex congenital heart disease, 1- MISC), HFNC: 3 (acute bronchiolitis), nasal cannula: 1]. One patient needed nitric oxide. No one needed vasoactive, inotropic support, or renal replacement therapy. Seventeen percent had elevated liver enzymes, while increased pro-BNP and troponin were seen in 15%, and 12% respectively. Positive blood culture and urine culture were seen in 9.1% (n=33) and 23.3% (n=30) respectively, and 1 was diagnosed with aseptic meningitis. One patient was admitted with acute COVID-19 at 9 months of age and was readmitted with MIS-C 5 months later.
Conclusion: Infants represented a high percentage of hospitalizations among children, but classic pneumonia with hypoxia or MIS-C were less common, ICU utilization was low, and co-infections were prevalent. Characterization of infantile SARS-CoV-2 infection may inform efforts for improved health outcomes.